Seem to be moving backward - Printable Version

Seem to be moving backward - Printable Version

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Seem to be moving backward - Saskie - 11-19-2016

Since beginning therapy a few weeks ago, I have found that I wake less frequently, but still up a number of times during the night.

After a few days, things were progressing on API, but have since adjusted to try to improve.

Original setting was 5 cm - 10 cm with auto ramp. Eventually adjusted by my therapist from 7.2 to 16 with auto ramp. Am attaching the best result from that time.

Lately in an effort to get better results, I have moved to 8 cm to 16 cm with no auto ramp. It's deteriorating as you will see below. Leak rate is up, but I don't think its mouth leak - no dry mouth.

Any suggestions are most appreciated.

Good Sleepyhead chart posted as well as last night's.

RE: Seem to be moving backward - Saskie - 11-19-2016

Since posting, I have had the benefit of trying to track the graphs with the wiki on Sleepyhead usage. Seems to me (as was noted earlier on here when I first started that most of the problem arises as the session is beginning, such that a big increase in pressure is required?

Also wondering if posture can contribute. Should I be concerned about neck position or anything along that line?

Thanks

RE: Seem to be moving backward - Galactus - 11-19-2016

Hang in there, someone who reads these graphs better than I do will be along to help. I used to be better at this, but as I started to feel better I kind of slacked off looking every day, and don't know this as well as I should. Might be time for me to go back and read through it all again, get my refresher course.

RE: Seem to be moving backward - PaytonA - 11-19-2016

It looks to me like your higher AHI was simply due to poor sleep. I am guessing here but it looks to me like a lot of your AHI on the high AHI night was sleep/wake junk which is normal. Any idea why you awakened so many times?

Generally my AHI is below 1.0 but if I have a bad nights sleep, it might go up to 3 or 4. Usually my bad nights sleeps are due to not being able to turn my mind off. If you have insomnia or other things like that I would recommend a book titled Sound Sleep, Sound Mind by Barry Krakow MD. I am in the middle of reading it right now and it is excellent. I do not have insomnia but on occasion have trouble getting to sleep or staying asleep.

Best Regards,

PaytonA

RE: Seem to be moving backward - Saskie - 11-19-2016

(11-19-2016, 11:47 AM)Galactus Wrote: Hang in there . . .

Thanks. I'm committed to the process but don't want to flail away mindlessly. Truly appreciate the support.

RE: Seem to be moving backward - Saskie - 11-19-2016

(11-19-2016, 12:34 PM)PaytonA Wrote: It looks to me like your higher AHI was simply due to poor sleep. I am guessing here but it looks to me like a lot of your AHI on the high AHI night was sleep/wake junk which is normal. Any idea why you awakened so many times ...

It's a pattern that has existed a number of years. Seems better since therapy started but still hard to shake. Last night was the worst yet but the upcreep in AHI has been going on a week now.

Thanks for the pointer on the book. I am going looking for it today.

RE: Seem to be moving backward - Sleeprider - 11-19-2016

You're using EPR at 1, and I was wondering if you have ever considered a higher exhale pressure relief? EPR or bilevel pressure support is often used for hypopnea. I'm not sure that increasing pressure is the full answer her as you don't have obstructive apnea events, and flow limitation is mild to moderate. It could just be you need some extra help in fully exhaling so you improve on respiratory volume (hypopnea). Want to give it a try?

RE: Seem to be moving backward - Galactus - 11-19-2016

(11-19-2016, 12:57 PM)Saskie Wrote:
(11-19-2016, 11:47 AM)Galactus Wrote: Hang in there . . .

Thanks. I'm committed to the process but don't want to flail away mindlessly. Truly appreciate the support.

You're in the right place, and are asking for help, you're in good hands. I might have quit if not for the people here. They talked me through scrapping the junk machine the DME gave me, buying a better one, setting it up, and tweaking it. You're at the right place, do what they suggest, post the results, and believe me they'll help you.

RE: Seem to be moving backward - Saskie - 11-19-2016

Makes sense. I'll try it tonight.

RE: Seem to be moving backward - Sleepster - 11-19-2016

(11-19-2016, 10:35 AM)Saskie Wrote: Leak rate is up, but I don't think its mouth leak - no dry mouth.

No dry mouth means nothing. Your leak rate graph shows signs that you are leaking, and my guess is it's mouth-leaks. Try a chin strap. If that doesn't work, a full face mask.

Those leaks are likely due to the higher pressure. They ruin your sleep because they either render the therapy ineffective, wake you up, or both.